阿德福韦酯治疗慢性乙型病毒性肝炎96周疗效观察

目的 观察阿德福韦酯治疗慢性乙型病毒性肝炎患者96周的临床疗效.方法 选取慢性乙型病毒性肝炎患者80例,予阿德福韦酯(1mg/d)抗病毒治疗;服药12周时行HBV DNA检测,无早期应答者(病毒载量下降<2 log10拷贝/ml)予改用其他核苷类药物.疗程96周,观察血清转氨酶(ALT)复常率、HBV DNA阴转率、HBeAg消失率和HBeAg血清转换率.结果 61例有早期应答患者在治疗第96周时ALT复常率达85.25%(52/61),HBV DNA阴转率为95.08%(58/61),HBeAg消失率为51.52%(17/33),而HBeA8血清转换率为42.42%(14/33);治疗至96周时有2例发生病毒学反弹.19例于12周时因无早期应答而改用其他核苷类似物患者,96周时的ALT复常率为57.89%(11/19),HBV DNA阴转率为68.42%(13/19),HBeAg消失率及HBeAg血清转换率均为58.33%(7/12).结论 阿德福韦酯对慢性乙型肝炎患者能有效抑制HBV复制,长期服用有较好疗效;对无早期应答病例及早换药有助提高疗效.

Efficacy of the 96-week adefovir dipivoxil therapy in patients with chronic hepatitis B

Objective To investigate the efficacy of the 96-week antiviral therapy with adefovir dipivoxil in patients with chronic hepatitis B.Methods 80 patients with chronic hepatitis B received the antiviral therapy of adefovir dipivoxil(ADV,10mg/d).At the 12th week,19 cases without early viral response(EVR,HBV DNA drop<2log10copies/ml)switched to the therapy of other nucleoside analogues.Aminotransferase(ALT)normalization,HBV DNA negative,HBeAg loss and HBeAg seroconvertion were accessed at the 96th week.Results At week 96,ALT normalization and HBV DNA negative in 61 patients with ADV therapy were 85.25%(52/61)and 95.08%(58/61);and HBeAg loss and HBeAg seroconvertion were 52.52%(17/33)and 42.42%(14/33)respectively.While for the other 19 patients switching to other nucleoside analogues.ALT normalization and HBV DNA negative came to 57.89%(11/19)and 68.42%(13/19).Both HBeAg lOtis and HBeAg seroconvertion were 58.33%(7/12).Conclusion Long term ADV antiviral therapy is effective to inhibit HBV DNA replications and benefits patients with chronic hepatits B.Switching to another nucleoside analogue is an optimal alternative if there is no EVR at week 12 in ADV therapy.